I Can't Win

I feel like death today.

Forgive me in advance if this post feels a little self-pitying. I try so hard to stay away from feeling sorry for myself, but good Lord these last few days have been nothing short of terrible.

Just when I started to feel like I had more energy and didn't have to walk around in an awkward position because of my swelly belly and incision pain, my body revolted.

My surgery was June 17th. On June 28th (a Saturday), I ended up back at the cancer center in their direct referral center (like an emergency room) because I was bleeding pretty profusely. Of course, by the time I arrived, the bleeding had mostly stopped. The doctors asked me if I had a bleeding disorder. Nope. Are you sure? Yes. Did you have heavy menstrual periods? Yes, but only because of the 1920987456 issues with my reproductive system. Frequent nosebleeds? Nope. Bruising easily? NO. For the love of God I don't have a bleeding disorder!  After pulling a few golfball-sized blood clots out of me, the resident and fellow declared that everything was fine and my bleeding was normal. And then sent me on my merry way. I felt a little dismissed, and a little irritated that the amount of fresh blood leaving my body 11 days after surgery was deemed normal. I went home and rested a bit.

The next day was hubby's 30th birthday, and I felt awful that I couldn't make it a special day for him. I opted to let him sleep in, and watched the baby for the majority of the day for him, but I felt pretty ok. Exhausted, but ok. The next day, hubby returned to work and my in-laws watched the baby for me so I could rest. It was much needed, because I was in a decent amount of pain all day. I was getting discouraged that it seemed to be taking so much longer for me to heal than I had anticipated. The next day was fine, but again, I felt pretty tired and was in some pain. I was also "spotting" or bleeding just a tiny bit, but nothing dramatic.

My 2-week post-op appointment was scheduled for Wednesday July 2nd. Between 6/28 (when I went to the hospital for bleeding) and 7/2, I had bouts of bleeding that would increase, and then suddenly decrease. I didn't think much of it, but was tired of all the blood. During my post-op appointment, the doctor decided to take a look and found an area of active bleeding, which she said was "unusual" for two weeks after surgery. She cauterized it with silver nitrate and omg it sucked so bad. I remember her saying "this might sting a little" and it did sting a little. Then it stung A LOT. Having been traumatized so many times over the last few months, I feel generally dizzy and lightheaded any time I'm being examined in the first place. Add some pain to that situation and I felt like I was going to pass out. But I didn't, and it was over pretty quickly, although she used at least 6 silver nitrate sticks, which look like really long matches and also feel like someone is putting burning matches into you. So the appearance was appropriate.

I met hubby for lunch and kept having this awful shooting pain from where the silver nitrate was applied that shot up towards my belly button. I told hubby that I wasn't sure I'd be able to go grocery shopping if the pain continued and that I needed to go home and lie down. I got a new prescription for some non-narcotic pain meds, went home, and plopped into bed. The shooting pain continued, but I happily posted on Facebook that I was released from the cancer center because there was no evidence of invasion and therefore no need for further monitoring by the oncologist since all of my girly bits had been taken out. Woo! I could finally start to put this behind me. And then... I felt a gush. Eff.

Yep. I was bleeding again. **Here's the part you may want to skip if you're squeamish about blood. I called the doctor's office just before 3pm to explain that I had just been there earlier in the day but was now bleeding pretty badly. The nurse who took my call didn't seem to think it was that big of a deal, and said "hopefully someone will call you back today." After about an hour, I called back and spoke with someone else, who clearly understood my concern and went to find my doctor. At this point, I was at the "bleeding through a sanitary pad an hour" level of bleeding, which is the benchmark of "something is wrong." They called back and scheduled me an appointment for first thing the next morning, but told me I could go to the ER if I wanted to. This lady was incredibly sweet, and warned me to lie down for the rest of the night and she was hopeful that all of this awfulness would stop. If I was comfortable waiting and monitoring overnight, I could be examined in the morning. But if at any point I started to bleed through three pads an hour, I HAD to go to the ER. There was no choice if I got to that point. The direct referral beds were full when I spoke with them just before 5, so going back down to the cancer center wasn't an option. Being stubborn as I am, I told myself that there was no way I was going somewhere in the middle of the night, and certainly not going to the ER if at all possible. Hubby came home with the baby and got her ready for bed, and I tried my best to stay calm and lie down.

There's a level of panic that is unavoidable when your body is losing so much blood at one time. By about 9:30, I knew my plan of watching-and-waiting was out the window. I called the on-call doctor, who told me to wait another hour. If my bleeding continued at the level it was at, or got any worse, I was to call back and he would see if there was a bed available at the cancer center. An hour later, I called back. It hadn't gotten any better, and now I was getting scared. On top of being scared, I was in pain that was rapidly increasing. There was a bed available, and off we went (after my dear stepmother-in-law came over so someone was with the baby overnight). I remember feeling awful that we'd come back in the middle of the night and have to wake her up. I was wrong about that.

The ride to the cancer center takes about 45 minutes. I was in horrible pain the whole way, and terrified. I had been down this road twice before, but not like this. The bleeding was far worse, and there was incredible pain and pressure. I prayed that my insides weren't falling out (that can happen after a hysterectomy but do yourself a favor and don't google it). When we arrived and I got out of the car, I was greeted with a gush and warmth down my leg. Awesome, now I get to hobble into the hospital with blood all over my pants. They immediately got me into a room, and my attempts at staying calm were becoming futile. I was losing so much blood and was in so much pain that I couldn't think straight or form much of a complete thought. Luckily my nurse was a-maze-ing and made me feel at ease. He kept things lighthearted and refused to let me get crabby. Once I was all hooked up to the machines, the direct referral center's doctor came to see me. The nurse let him know that my blood pressure was 145/101 and my heart rate was 115. The doctor was cool as a cucumber, but clearly concerned at every stat they threw at him. Great. The doctor told me he'd let the gyn on-call do the exam, but was worried about my symptoms and blood loss and that, depending on the results of my labs, I may need a blood transfusion. Omg. Please no. I begged for something for the pain, and they gave me a tiny dose of morphine which did nothing at all.

When the gyn resident came in to see me, she told me she was going to examine me. I'll spare you the details, but there was blood everywhere. Like, everywhere. Even all over my shirt. One look, and the resident clearly knew this was beyond her ability and paged the on-call fellow. They gave me something stronger for the pain. When the fellow came in, things got hairy. The pain was so intense, and there was so much blood, that we didn't really get  very far. He felt my stitches were intact, but was really worried about how much blood I was losing. They decided to admit me for the night and do a CT scan to make sure there was no internal bleeding. It was almost 3am by the time they were done with examining me. I don't typically cry from pain, but I was hysterical after they were done- partly from pain, and partly from the trauma of the whole situation. Then they brought me my contrast solution to drink for my CT scan. I had my scan at about 4am, then finally got to my room. By then, the pain was gone. As it turns out, there was such a large volume of blood clots that it was putting some major pressure on my innards and causing me such great pain. So once the clots were pulled out, the pressure and pain went away. I finally got to try to sleep around 5am, but was up again at 6:30 and every hour after that with doctors and nurses coming in, asking me questions, and drawing blood.

For some unknown reason, the bleeding slowed way down on its own. The CT scan didn't show any internal bleeding (whew) but my hemoglobin and potassium levels crashed, so I had to stay overnight again. They gave me IV potassium which ruined any shred of comfort I finally had. My whole left arm felt like it was going to fall off, even after they slowed my infusion rate by half. The doctor finally agreed to let me eat (did I forget to mention that I hadn't eaten anything since a Greek yogurt at 9pm, and before that was just the lunch I ate with hubby after my appointment?) at about 1pm on 7/3 and they discontinued the potassium via IV, and opted for potassium pills instead. Hallelujah. I went downstairs for another exam, but only after being given oral Ativan and IV dilaudid to calm me the hell down before my exam. The doctor got smart, realizing how traumatized I've been over the last few months of lying on tables having massive blood clots pulled from my body. The exam went well and the doctor patched me up, and felt confident that my bleeding was done, at least for now. After the Dilaudid and Ativan combined with the complete lack of sleep from the night before, I was pretty much dead to the world from about 7:30pm until the next morning. I was finally free to go home in the morning on 7/4. Happy 4th of July to me.

I don't have a bleeding disorder. They tested my blood clotting three different times and all was normal. So no one has any idea why I've bled so badly so many times after these last two surgeries. Upon exam, the area that was bleeding was so tiny, that it really didn't explain why I bled so much.

I lost about 10% of my blood volume in just a few hours. My hemoglobin dropped from 13 (when I arrived at the hospital) to less than 10 by the next morning. My body reacted in some pretty dramatic ways- My white blood cell count shot up in response to the amount of blood I was losing, and my pelvic lymph nodes swelled. My body was preparing for the worst and sending in the troops to fight the battle.

I slept for about two hours yesterday afternoon. I still feel awful... I'm nauseated, exhausted, and weak. If I stand up too quickly, I feel dizzy and lightheaded. My arms and legs feel heavy, yet I look like a frail old woman; I've lost about 6 pounds since my surgery, and I was already slightly underweight to begin with. The last few days are pretty much a blur.

I'm hoping it's not long before my energy level returns... I'm supposed to return to work in a week or two. That's if I don't start bleeding again. Hmph.